Individual
SHANISA HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
121 S EUCLID AVE, WESTFIELD, NJ 07090-2129
(908) 232-2903
Mailing address
28 VALLEY RD STE 1, MONTCLAIR, NJ 07042-2709
(732) 893-7673
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41S01209600
NJ
235Z00000X
Speech-Language Pathologist
TL-3963
NJ
Other
Enumeration date
11/08/2022
Last updated
02/05/2025
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